Electrosurgical devices, systems and methods of using the same

ABSTRACT

According to an aspect of the present disclosure, a desiccation device for operation on a target tissue is provided. The device includes a handle; a shaft extending distally from the handle, wherein the shaft defines a lumen therethrough; and a head having a loop configuration supported on a distal end of the shaft, the head being hollow and defining a lumen therethrough, said lumen being in fluid communication with the lumen of the shaft. At least a portion of the cutting head is electrically connected to a source of electrosurgical energy. A fluid is circulatable through the lumen of the shaft and the head.

BACKGROUND

1. Technical Field

The present disclosure relates to electrosurgical devices and, moreparticularly, to electrosurgical devices, systems, and methods thatinclude one or more lumens adapted to operatively connect to one or moreoutside sources.

2. Discussion of Related Art

Electrocauterization, commonly referred to as electrosurgery, is acommonly used medical technique whereby radio-frequency (RF) and otherforms of energy are used to treat and/or to remove tissue. Tissue thatis to be treated and/or to be removed may be located in a wide varietyof targets within the body, including but not limited to the abdominalorgans, the thoracic cavity and lymphoid tissue, including the tonsilsand adenoids.

Typically, electrocauterization is performed using electrosurgicaldevices (e.g., suction coagulator, commercially available ValleyLabInc., and sold as product No. E2G12-6, or other suitable electrosurgicalcurette), which may include an RF electrode configured to ablate, seal,desiccate and/or coagulate tissue. Generally, the desiccation and/orcoagulation electrode is coupled between a power source, e.g., anelectrosurgical generator, (outside the body) and a dispersive returnelectrode (e.g., a return electrode) or an indifferent electrode, e.g.,return electrode, for contacting a large surface of the body. When an RFvoltage is provided between the desiccation and/or coagulation electrodeand the return electrode, RF current flows between the desiccationand/or coagulation electrode through the body and to the returnelectrode. Typically, the current density is very high near the tip ofthe desiccation and/or coagulation electrode, which heats the adjacenttissue.

An important criterion when using electrode desiccation and/orcoagulation systems relates to the temperature of the electrode achievedduring the desiccation and/or coagulation process. Specifically, it maybe desirable to control or maintain the temperature of certaindesiccation and/or coagulation electrodes, of a given electrode tipgeometry, such in order to maximize coagulation. Limiting thetemperature of the electrode prevents the desiccated tissue fromoverheating. Over heated tissue may stick to or accumulate on or nearthe electrode and/or the treated tissue.

Electrosurgery is frequently used today to achieve hemostasis, such as,for example, when excising, scraping, and/or sculpting tissue. Excisingtissue may require a clinician to scrape and/or slice off a thin sectionof tissue. This may be achieved with a sharp electrosurgical curetteand/or suction coagulator. Typically, after excising tissue with a sharpedge, control of hemostasis is lost, and the electrosurgical curetteand/or suction coagulator is used to regain control of the ensuingbleeding. In this instance, the electrosurgical curette and/or suctioncoagulator may provide surface desiccation and/or coagulation to thesurrounding hemorrhaging tissue. However, because current densities ator near the tip of the electrode may become very high, eschar (thermallydeadened and oxidized protein) may sometimes stick to or accumulate onor near the electrode and the treated tissue. Eschar sticking oraccumulating at or near the electrode may become problematic. Forexample, eschar sticking or accumulating at or near the electrode maycause a clinician further/continued loss control of the hemostaticeffect delaying progress in a surgical procedure.

Commercially available electrosurgical curettes, such as, for example,those disclosed in U.S. Pat. No. 6,749,608 to Garito et al., include anelongated structure defining a central axis therethrough. The elongatestructure includes a handle at a proximate end thereof. The elongatedstructure terminates in a downwardly extending claw-shaped end.Suspending from the claw-shaped end is a non-cooled cutting blade.Because the cutting blade of the electrosurgical curette of the '608patent has a sharp blade edge and is non-cooled, there is limitedability to provide an effective hemostasis as it is cutting throughtissue.

A similar electrosurgical curette is described in U.S. Pat. No.6,802,842, to Ellman et al. The curette of the '842 patent includes atonsil and adenoid device that includes an electrode with anelectrically conductive cutting edge. While the '842 patent describesthat a fluid source may be connected to the electrosurgical curette, thefluid source is not in fluid communication with the electrode. Becausethe cutting blade of the curette of the '842 patent is substantiallysharp and non-cooled, there is limited ability to provide an effectivehemostasis as it is cutting through tissue.

Accordingly, a need exists for the manufacture of electrosurgicaldevices for tissue desiccation and/or coagulation, systems for tissuedesiccation and/or coagulation that include the electrosurgical devicesand methods for desiccating and/or coagulating tissues using cooled RFdesiccation and/or coagulation devices.

SUMMARY

The present disclosure provides a desiccation device configured foroperation on a target tissue. The desiccation device includes a handle,and a shaft extending distally therefrom, wherein the shaft defines alumen. Supported at a distal end of the shaft is a head having a loopconfiguration. The head is hollow and defines a lumen, wherein the lumenis in fluid communication with the lumen of the shaft, such that a fluidis circulatable through the lumen of the shaft and the head. In anembodiment, at least a portion of the scraping head is electricallyconnected to a source of electrosurgical energy.

The present disclosure also provides a desiccation device for operationon a target tissue, wherein the desiccation device includes a handle, ashaft extending distally from the handle, and a scraping head supportedon a distal end of the shaft. The desiccation device includes a probeoperatively supported by either the handle or the shaft. The probeincludes an in-flow tube, an out-flow tube concentrically disposed aboutthe in-flow tube and a loop supported at a distal end of the out-flowtube.

In embodiments, the loop may be hollow and may be disposed in fluidcommunication with the in-flow tub and the out-flow tube. A fluidcirculates through the loop by way of the in-flow tube and the out-flowtube. A source of electrosurgical energy may be connected to theelectrosurgical device. In embodiments, the loop of the probe may beconnected to a source of electrosurgical energy.

Additionally, the present disclosure provides a surgical device foroperation on a target tissue. The device may include a tubular bodyportion defining a lumen therethrough and a hollow electrode operativelyassociated with the tubular body. The electrode may include a firstportion and a third portion each extending along a length of the tubularbody. Each of the first and third portions of the electrode may befluidly connected to a fluid source. The electrode also may include asecond portion that extends radially around a portion of the peripheryof the tubular aspiration body. The interior of the aspiration body maybe selectively coated to prevent electrosurgical current from furtherdesiccation of aspirated tissue.

Moreover, the present disclosure provides a surgical device foroperation on a target tissue. The device includes a shaft that defines alongitudinal axis, supports a suction lumen and is adapted to connect toa fluid source. Operatively connected to a distal end of the shaft is anelectrode that includes a scraping edge. In embodiments, a portion ofthe electrode is disposed in a fixed spaced apart relation relative tothe suction lumen such that the suction lumen may aspirate coagulatedtissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Further features and advantages of the invention will become readilyapparent from the following specification and from the drawings, inwhich:

FIG. 1 is an isometric perspective view of a desiccation deviceaccording to an embodiment of the present disclosure;

FIG. 2 is a top, plan view of the desiccation device of FIG. 1;

FIG. 3 is a front elevational view of the desiccation device of FIGS. 1and 2;

FIG. 4 is a schematic illustration of a desiccation system, includingthe desiccation device of FIGS. 1-3 shown in cross-section;

FIG. 5 is an enlarged view of the indicated area of detail of FIG. 4;

FIG. 5A is an enlarged view of the indicated area of detail “5” of FIG.4, illustrating an alternate embodiment of the present disclosure;

FIG. 6 is an isometric perspective view of a desiccation deviceaccording to another embodiment of the present disclosure;

FIG. 7 is a top, plan view of the desiccation device of FIG. 6;

FIG. 8A is a front elevational view of the desiccation device of FIGS. 6and 7;

FIG. 8B is a front elevational view of an alternate embodiment of thedesiccation device of FIG. 8A;

FIG. 9 is a side, elevational view of a desiccation device according toyet another embodiment of the present disclosure;

FIG. 10 is a top, plan view of the desiccation device of FIG. 9;

FIG. 11 is a front elevational view of the desiccation device of FIGS. 8and 9;

FIG. 12 is a side, elevational view of a distal end of a surgical deviceaccording to an embodiment of the present disclosure;

FIG. 13 is a front, elevational view of the surgical device of FIG. 12;

FIG. 14 is a side, elevational view of a distal end of a surgical deviceaccording to another embodiment of the present disclosure;

FIG. 15 is a front, elevational view of the surgical device of FIG. 14;

FIG. 16 is a side, elevational view of a distal end of a surgical deviceaccording to yet another embodiment of the present disclosure;

FIG. 17 is a front, elevational view of the surgical device of FIG. 16;

FIG. 18 is a side, elevational view of a distal end of a surgical deviceaccording to still another embodiment of the present disclosure;

FIG. 19 is a front, elevational view of the surgical device of FIG. 18;

FIG. 20 is a perspective view of a surgical device according to anotherembodiment of the present disclosure;

FIGS. 21A-21D are traverse, cross-sectional views illustrating differentshapes of electrode assemblies, in accordance with the presentdisclosure, that may be employed with the surgical device depicted inFIG. 20;

FIG. 22 is a perspective view of a surgical device according to anotherembodiment of the present disclosure; and

FIG. 23 is a flow chart illustrating a method, in accordance with thepresent disclosure, for performing a surgical procedure.

DETAILED DESCRIPTION OF EMBODIMENTS

In the drawings and in the descriptions which follow, the term“proximal”, as is traditional, will refer to the end which is closer tothe user, while the term “distal” will refer to the end which is furtherfrom the user.

For illustrative purposes only, the electrosurgical devices describedherein, will be described in terms of electrosurgical systems thatinclude RF desiccation and/or coagulation modes. As mentioned above, thepresent disclosure relates to electrosurgical devices that employ RFdesiccation and/or coagulation electrodes. The electrosurgical devices,as described herein, may be configured to operate in different modes ofoperation, e.g., ablate, desiccate, coagulate, and/or seal.Additionally, the electrosurgical devices, as described herein, may beadapted to connect to one or more different sources (e.g.,electrosurgical generator) for producing a desired effect.

Referring now to the figures, in which like numerals indicate likeparts, and particularly to FIG. 1, desiccation device according to anembodiment of the present disclosure is shown generally as 100. As seenin FIG. 1, desiccation device 100 includes a handle 102, a shaft 104extending coaxially from handle 102, and a head 106 supported on orformed at a distal end 104 a of shaft 104. Handle 102 and shaft 104 maybe substantially aligned along a common longitudinal “X” axis thereofor, in the alternative, may be parallel to one another and off-axis ormay be angled with respect to one another.

The specific configuration of head 106 may best be seen with referenceto FIGS. 2 and 3. As shown therein, head 106 is in the form of a loop.In an embodiment, head 106 may include a pair of diverging arms 108 a,108 b and a cross-bar 110 extending between the distal ends of arms 108a, 108 b. Cross-bar 110 may or may not be sharpened as needed to achievethe correct speed of cutting balanced against the level of desiccationcoagulation. Arms 108 a, 108 b of head 106 extend in a direction that isgenerally transverse to the longitudinal “X” axis.

Handle 102, shaft 104 and head 106 may be formed as a unitaryconstruction of a suitably electrically conductive material. It iscontemplated that at least a portion of each of handle 102, shaft 104and head 106 may be covered with a suitably electrically insulativematerial or the like. In an embodiment, as best seen in FIGS. 4 and 5,desiccation device 100 includes a handle 102 constructed of a suitableelectrically insulative material, and a shaft 104 and head 106fabricated from a suitable electrically conductive material, such as,for example, stainless steel, titanium, etc. As seen in FIGS. 4 and 5,at least a portion of the length of shaft 104 is covered with a suitableelectrically insulative material 112. It is envisioned that insulativematerial 112 may extend to cover at least a portion of arms 108 a, 108 bof head 106 thereby solely exposing cross-bar 110 as an activeelectrosurgical electrode.

As seen in FIG. 4, shaft 104 and head 106 are electrically connected toa source of electrosurgical energy or generator “G” via a conduit 116(e.g., wire, cable, etc.). A suitable generator “G” should be capable ofdelivering at least one energy frequency ranging from about 100kilohertz to about several hundred megahertz.

With continued reference to FIGS. 4 and 5, shaft 104 and head 106 arehollow and define a lumen 114 therein and/or therethrough. Desiccationdevice 100 includes an in-flow tube 120 disposed within lumen 114.In-flow tube 120 includes a distal end 120 a that is in close proximityto the portion of lumen 114 defined by head 106. As seen in FIGS. 4 and5, distal end 120 a of in-flow tube 120 may extend into the portion oflumen 114 defined by head 106. A fluid-tight seal may be created, at apoint where in-flow tube 120 extends into a portion of lumen 114 definedby head 106, by joining distal end 120 a, or portions thereof, to lumen114. In this instance, cooling fluid is prevented from flowing back intothe portion of lumen 114 defined by head 106 before entering distal end122 a of out-flow tube 122. This configuration may provide a maximumcooling effect to head 106. In-flow tube 120 includes a proximal end 120b extending through handle 102 which fluidly connects or is connectableto a source of fluid “FS”.

As seen in FIG. 4, desiccation device 100 includes an out-flow tube 122having a distal end 122 a in fluid communication with lumen 114 of shaft102, and a proximal end 122 b extending from handle 102 which fluidlyconnects or is connectable to fluid source “FS”.

Desiccation device 100 includes one or more hubs 128 (see FIG. 4)supported within handle 102. Hub 128 functions to create one or morefluid-tight seals for lumen 114 between lumen 114 and in-flow tube 120and out-flow tube 122.

The components of desiccation device 100 are not drawn to scale.Accordingly, it is envisioned that the relative sizes of the componentsmay vary depending on the intended purpose. For example, it iscontemplated that a diameter of in-flow tube 120 may be selected tomaximize fluid deliver and that the diameter thereof may taper, in adistal direction, so as to form head 106. It is further contemplatedthat a cross-sectional diameter of the tube making up head 106 may beshaped or sized to balance the desiccating, cutting and/or debridingeffect of head 106. It is further contemplated that cross-bar 110 ofhead 106 may have a round, transverse cross-sectional profile and/orthat a diameter of cross-bar 110 of head 106 may be smaller than adiameter of in-flow tube 120.

In operation, either prior to, during or after activation of generator“G”, as electrosurgical energy is delivered to head 106, a cooling fluid“F” (e.g., water, saline, etc.) is circulated through lumen 114. Fluid“F” is fed, from the source of fluid “FS”, through in-flow tube 120 tothe portion of lumen 114 defined by head 106, circulated around thatportion of lumen 114, back through lumen 114 extending through shaft104, and out through out-flow tube 120 and back to the fluid source“FS”.

In an embodiment, as seen in FIG. 5A, it is contemplated that out-flowtube 122 may extend distally to and fluidly connect with arm 108 b ofhead 106. As such, it is envisioned that a single unitary tube may beused to form in-flow tube 120, head 106 and out-flow tube 122.

It is further contemplated that a distal end of in-flow tube 120 and/orout-flow tube 122 (not shown), e.g., distal of hub 128, may be disposedin a support tube or respective support tubes (not shown) or the like.

Circulation of fluid “F”, as described above, may be established with apump (not shown). The rate of circulation of fluid “F” may be increasedor decreased in order to adjust the temperature of head 106 as needed. Aprobe (not shown) may be connected to head 106 which may sense thetemperature of head 106 during the surgical procedure. The probe may beconnected to generator “G” and/or the fluid source “FS” in order toprovide generator “G” and/or the fluid source “FS” with feedback andthus enable generator “G” and/or the fluid source “FS” to be adjusted asneeded and/or desired.

In operation, with head 106 activated and fluid “F” circulatingtherethrough, head 106 is advanced through to desiccate tissue withoutsubstantial production of eschar or the like. The desiccated tissue maythen be excised (e.g., cut) as desired and/or needed.

Turning now to FIGS. 6-8B, a desiccation device according to analternate embodiment of the present disclosure is shown and described.The desiccation device of FIGS. 6-8B is substantially similar to thedesiccation device of FIGS. 1-5 and thus will only be described hereinto the extent necessary to identify differences in construction and/oroperation.

As seen in FIGS. 6-8B, desiccation device 100 may include either ahollow or solid shaft 104 and/or head 106. Shaft 104 and/or head 106 maybe fabricated from a suitable electrically conductive material, asuitable electrically insulative material, or a combination thereof. Itis envisioned that cross-bar 110 of head 106 may define a knife edge orthe like for severing and/or cutting though tissue before, during orafter desiccation of said tissue.

With continued reference to FIGS. 6-8B, desiccation device 100 includesa probe 150 operatively connected to handle 102 and/or shaft 104. Asbest seen in FIGS. 8A and 8B, probe 150 may have a width that is lessthan head 106 (FIG. 8A), or greater than cutting head 106 (FIG. 8B).Probe 150 includes an outer or out-flow tube 152 and a concentric inneror in-flow tube 154. Probe 150 further includes a loop 156 formed orsupported at a distal end 152 a of out-flow tube 152. Loop 156 may behollow in order to allow fluid “F” to circulate therethrough. It isenvisioned that a distal end of in-flow tube 154 is located in closeproximity to the hollow cavity of loop 156. In this manner, fluid “F”may be delivered to and circulated around loop 156 by in-flow tube 154and carried away by out-flow tube 152.

As seen in FIGS. 6-8B, loop 156 is located proximally of head 106. Inthis manner, as desiccation device 100 is moved in a proximal direction,as indicated by arrow “A”, loop 156 is maintained ahead of head 106 tothereby desiccate the target tissue prior to the cutting of the targettissue by cross-bar 110 (e.g., a cutting knife of blade).

In one embodiment as seen in FIG. 6, probe 150 may include one or morespring elements 158 formed in out-flow tube 152 and in-flow tube 154that are concentric with one another. Spring elements 158 provide probe150 with a degree of resiliency during its movement over and against thetarget tissue.

Turning now to FIGS. 9-11, a desiccation device according to analternate embodiment of the present disclosure is shown and described.The desiccation device of FIGS. 9-11 is substantially similar to thedesiccation device of FIGS. 6-8 and thus will only be described hereinto the extent necessary to identify differences in construction and/oroperation.

As seen in FIGS. 9-11, desiccation device 100 includes a probe 160operatively and slidably connected to handle 102 and/or shaft 104. Probe160 includes an outer or out-flow tube 162 and a concentric inner orin-flow tube 164. Probe 160 further includes a loop 166 formed orsupported at a distal end 162 a of out-flow tube 162. Loop 166 may behollow in order to allow fluid “F” to circulate therethrough. It isenvisioned that a distal end of in-flow tube 164 is located in closeproximity to the hollow cavity of loop 166. In this manner, fluid “F”may be delivered to and circulated around loop 166 by in-flow tube 164and carried away by out-flow tube 162.

As seen in FIGS. 9-11, loop 166 may be located proximally of cuttinghead 106. In this manner, as desiccation device 100 is moved in aproximal direction, as indicated by arrow “A”, loop 166 is maintainedahead of cutting head 106 to thereby desiccate the target tissue priorto the cutting of the target tissue by cutting knife 110. Additionally,since probe 160 is slidably connected to handle 102 and/or shaft 104,probe 160 may be moved relative thereto such that loop 166 may bepositioned distal of, or in juxtaposition to, cutting head 106. Themovement of probe 160 relative to handle 102, shaft 104 and/or cuttinghead 106 is indicated by double-headed arrow “B”.

It is contemplated that in an embodiment, desiccation device 100, ofFIGS. 9-11, may be configured as a bipolar device wherein head 106 maybe either an active or a return portion of a bipolar arrangement andloop 166 may be the other of the active or return portion of the bipolararrangement. In such an embodiment, it is further contemplated that eachof head 106 and loop 166 may be provided with a common or an independentfluid circulating therethrough in order to provide a cooling effectthereto.

Turning now to FIGS. 12 and 13, a surgical device according to anotherembodiment of the present disclosure is shown generally as 200. As seenin FIGS. 12 and 13, desiccation device 200 includes a body portion 202having a substantially tubular configuration and defining a lumen 204therein. Body portion 202 further defines a longitudinal “X” axis.

Surgical device 200 further includes an electrode 210 operativelyassociated with body portion 202. Electrode 210 includes a first portion210 a which extends longitudinally along an outer surface of bodyportion 202 towards a distal end 202 a thereof, a second portion 210 bwhich extends around at least a portion of the periphery of body portion202, and a third portion 210 c which extends longitudinally along theouter surface of body portion 202 towards a proximal end 202 b thereof.

As seen in FIGS. 12 and 13, second portion 210 b of electrode 210 islocated adjacent body portion 202. Additionally, second portion 210 bextends around the periphery of body portion 202 by an angle “θ” whichis less than about 180°, preferably, about 60°.

Body portion 202 may be fabricated from any suitable rigid material,including and not limited to, stainless steel, titanium, polycarbonate,polyvinylchloride and the like. Electrode 210 is fabricated from anysuitable electrically conductive material, including and not limited tostainless steel, titanium and the like. It is envisioned that at leastfirst portion 210 a and third portion 210 c of electrode 210 is coveredwith a suitable insulative material thereby leaving second portion 210 bthereof exposed.

Electrode 210 may be hollow thereby defining a circulation path forfluid to flow therethrough. It is envisioned that a proximal end offirst portion 210 a and second portion 210 b of electrode 210 are eachfluidly connected or connectable to fluid source “FS”. It is furtherenvisioned that electrode 210 is electrically connected or connectableto an electrosurgical generator “G”. Body portion 202 of surgical device200 may be connected to a vacuum source “VS” for creating a suctionthrough lumen 204 thereof.

In operation, with fluid circulating through electrode 210 and withelectrode 210 activated, the distal end of surgical device 200 may beapproximated toward a target tissue such that second portion 210 b maybe contacted with the target tissue and thereby desiccate the same. Asthe target tissue is desiccated and/or debrided, any smoke and/or loosetissue generated as a result thereof may be aspirated into body portion202. A selective coating 206 inside shaft 202 may be employed to preventRF flow through aspirated tissue reducing occlusion of lumen 204 bytissue chard to the inside surface.

Turning now to FIGS. 14 and 15, according to another embodiment ofsurgical device 200, second portion 210 b of electrode 210 may extendaround the distal end 202 a of the periphery of body portion 202 by anangle “θ” which is greater than about 180°, preferably, about 360°. Asseen in FIG. 14, second portion 210 b of electrode 210 is located distalof distal end 202 a of body portion 202.

Turning now to FIGS. 16 and 17, according to another embodiment of thepresent disclosure, surgical device 200 of FIGS. 12 and 13 furtherincludes a scraper 220 extending distally from distal end 202 a of bodyportion 202. Scraper 220 includes a finger 222 extending radiallyoutward from body portion 202 which functions to rake desiccated tissuein a proximal direction or push desiccated tissue in a distal direction.

Turning now to FIGS. 18 and 19, according to another embodiment of thepresent disclosure, surgical device 200 of FIGS. 14 and 15 furtherincludes a scraper 230 slidably disposed within lumen 204 of bodyportion 202 and extending distally therefrom. Scraper 230 includes afinger 232 extending radially outward from body portion 202 whichfunctions to rake desiccated tissue in a proximal direction or pushdesiccated tissue in a distal direction. A retainer 234 is providedwithin lumen 204 of body portion 202 to support scraper 230.

While first and third portions 210 a, 210 c, respectively, of electrode210 is shown disposed externally of body portion 202, it is envisionedand within the scope of the present disclosure for first and thirdportions 210 a, 210 c, respectively, to be disposed within lumen 204 ofbody portion 202.

As seen throughout FIGS. 12-19, second portion 210 b of electrode 210 isoriented substantially orthogonal to the longitudinal “X” axis and tothe longitudinal axis of first and/or second portions 210 a, 210 cthereof. However, it is envisioned that second portion 210 b may beoriented at any angle with respect to the longitudinal “X” axis.

Turning now to FIGS. 20-22, a surgical device 300 is shown. Surgicaldevice 300 is substantially similar to the surgical devices describedhereinabove and thus will only be described herein to the extentnecessary to identify differences in construction and/or operationthereof.

Surgical device 300 includes a shaft 302 having an electrode 310supported on, formed at or extending from a distal end 302 b thereof anda suction lumen 304 operatively connected thereto and extending from aproximal end 302 a to distal end 302 b of shaft 302. A selective coatingmay be applied to the inside of shaft 304 to reduce clogging. Surgicaldevice 300 is adapted to operatively connect to a generator “G” and avacuum source “VS”. A surgical device 400 may also be adapted tooperatively connect to a fluid source “FS”, to be described in greaterdetail below.

Shaft 302 may have a generally tubular structure defining a longitudinalaxis “X” therethrough. Shaft 302 may be configured to serve as a handlefor grasping thereof, or shaft 302 may be adapted to attach to a handle,not shown. Shaft 302 includes proximal end 302 a and distal end 302 b.Proximal end 302 a of shaft 302 a may be adapted to connect to generator“G”, vacuum source “VS” and/or fluid source “FS”. Shaft 302 may have asheathing or insulative coating (not shown) extending over at least aportion of a length thereof, or at least a portion of shaft 302 may bemade from a suitable non-conductive material.

Surgical device 300 includes a suction lumen 304 extending from orselectively extending from distal end 302 b of shaft.

Suction lumen 304 may be oriented substantially orthogonal to thelongitudinal “X” axis. Alternatively, suction lumen 304 may be orientedat any suitable angle θ with respect to the longitudinal “X” axis, asbest seen in FIG. 20. Suction lumen 304 may be constructed of a suitablenon-conductive material, or may have a suitable insulating materialcovering at least a portion thereof.

In one embodiment, suction lumen 304 may be a separate member attachedto shaft 302 via any suitable attaching means. Alternatively, suctionlumen 304 may be defined by shaft 302 or portion thereof.

As mentioned above, surgical device 300 includes an electrode 310located at distal end 302 b of shaft 302 and selectively extendabletherefrom. Electrode 310 may include one or more arms 312 (one arm isshown) that extends therefrom in a generally transverse orientationrelative to an axis thereof. Each arm 312 may be formed of a suitableelectrically conductive material that may be at least partially coatedwith a suitable insulative material. Alternatively, each arm 312 mayinclude an inner conductor surface and an outer non-conductive sheath(not shown). Surgical device 300 includes one or more fingers 314 (onefinger is shown) extending from arm 312.

When viewing at surgical device 300 from the front, finger 314 and arm312 of electrode 310 appear generally “L” shaped.

Finger 314 may extend from arm 312 in any suitable direction. Finger 314may have a variety of different geometric shapes and/or configurationsto include a leading conductive distal edge 314 a and a trailingnon-conductive proximal edge 314 b′. As seen in FIGS. 21A-21D, finger314 may have a transverse cross-sectional profile that resembles asquare, triangular, rectangle, trapezoid, and the like, or finger 314may have an irregular “free-form” shape (e.g., teepee, carrot).

Finger 314 may include a conductive surface 314 a in electricalcommunication with the generator “G”, and a non-conductive surface 314 bisolated from conductive surface 314 a. Conductive surface 314 a mayextend distally from an intermediate plane of finger 314 at an angle αthat is between about 0° and 90° (FIGS. 21A-21D) forming conductivedistal edge 314 a′ projecting distally from conductive surface 314 a.Non-conductive surface 314 b of finger 314 may extend proximally fromthe intermediate plane of finger 314 at an angle α′ that is betweenabout 0° and 90° (FIGS. 21A-21D) forming non-conductive proximalscraping edge 314 b′ extending from non-conductive surface 314 b.Additionally, conductive distal edge 314 a′ of conductive surface 314 aand scraping edge 314 b′ of non-conductive surface 314 b may be orientedat any angle θ relative to a distal end 304 a of suction lumen 304 toprovide more or less aggressive scraping depending on a particularpurpose. For example, conductive distal edge 314 a′ and scraping edge314 b′ may be oriented at an angle θ and θ′, respectively, that isbetween about 0° and 90° relative to the distal end 304 a suction lumen304, as best seen in FIGS. 21A-21D).

Distal edge 314 a′ may be configured to have a generally dull edge. Inan embodiment, edge 314 a′ and a proximal scraping edge 314 b′ of finger314 may each be angled or straight.

Scraping edge 314 b′ may be formed of non-conductive material, such as,for example, ceramic or high temperature plastic, e.g., liquid crystalpolymer. Alternatively, scraping edge 314 b′, or any portion thereof,may be coated with an insulative material. Scraping edge 314 b′ may beconfigured to have a minimal sharpness. That is, proximal edge 314 b′should be sharp enough to scrape or slough tissue that has beencoagulated, and pass over tissue that has not been coagulated.

Scraping edge 314 b′ may be in a fixed spaced apart relation relative tosuction lumen 304. In particular, scraping edge 314 b′ is spaced apartfrom suction lumen 304 at a distance “d” such that suction lumen 304 mayaspirate coagulated and/or desiccated tissue and aspirate fluids in theproximity of tissue being treated. As seen in FIGS. 20 and 22, distances“d” that scraping edge 314 b′ may be disposed from suction lumen 304include, and are not limited to, distances that are approximately lessthan or equal to the inner diameter (I.D.) of suction lumen 304.

For example, as seen in FIG. 20, for suction lumens 304 with an I.D. of12 French or less, scraping edge 314 b′ may be spaced apart from suctionlumen 304 by a distance “d” that is approximately equal to the I.D. ofsuction lumen 304. For suction lumens 304 with an I.D. that is greaterthan 12 French, as seen in FIG. 22, scraping edge 314 b′ may be spacedapart from suction lumen 304 by a distance “d” that is approximatelyless than the I.D. of suction lumen 304. As used herein, a “French” isapproximately equal to a diameter of the lumen times 3 mm.

The following steps are illustrative of one mode in which surgicalapparatus 300 may be employed. In operation, with distal edge 314 a′ ofelectrode 310 activated, distal edge 314 a′ is advanced over a desiredtissue to coagulate and/or desiccate the tissue. Subsequently, a layerof the coagulated and/or desiccated tissue may be scraped off via thescraping edge 314 b′ of electrode 310 and aspirated by suction lumen304. If additional layers of tissue have to be removed, they may beremoved employing the same or similar steps as herein described.

Turning now to FIG. 22, a surgical device 400 is shown. Surgical device400 is substantially similar to surgical device 300 describedhereinabove and thus will only be described herein to the extentnecessary to identify differences in construction and/or operationthereof.

Surgical device 400 includes a shaft 402 having an electrode 410supported on or formed at a distal end 402 b thereof and a suction lumen404 operatively connected thereto and extending from a proximal end 402a to distal end 402 b.

Surgical device 400 further includes an inflow conduit 420 and anoutflow conduit 422 each operatively fluid interfacing electrode 410with a fluid source “FS”. In an embodiment, inflow conduit 420 andoutflow conduit 422 may be defined by shaft 402 and may extend along alongitudinal length thereof.

While electrode 410 is illustrated as having the same or similarconfiguration to electrode 310, electrode 410 may have a loopconfiguration the same as or similar to the loop configuration describedwith reference to cutting head 106. Electrode 410 is hollow and definesa lumen 416 in fluid communication with inflow conduit 420 and outflowconduit 422 of shaft 402. In use, a fluid is circulatable through inflowconduit 420 and outflow conduit 422 of shaft 402 to cool electrode 410.

Inflow conduit 422 and outflow conduit 422 of shaft 402 may beconfigured the same as or similarly to in-flow tube 120 and out-flowtube 122 as described hereinabove.

The following steps are illustrative of one mode in which surgicalapparatus 400 may be employed. In operation, with distal edge 414 a′ ofelectrode 410 activated, distal edge 414 a′ is advanced over a desiredtissue to coagulate and/or desiccate the tissue. Subsequently, a layerof the coagulated and/or desiccated tissue may be scraped off via thescraping edge 414 b′ of electrode 410 and aspirated by suction lumen404. As mentioned above, if additional layers of tissue have to beremoved, they may be removed employing the same or similar steps asherein described. However, if numerous advancements of electrode 410over tissue are made, electrode 410 and/or any portion thereof maybecome too hot, and for at least the same or similar reasons statedabove, it may be useful to circulate fluid into electrode 410 or aportion thereof, via inflow and outflow conduits, 420 and 422,respectively, to cool electrode 410.

From the foregoing and with reference to the various figure drawings,those skilled in the art will appreciate that certain modifications canalso be made to the present disclosure without departing from the scopeof the same. For example, surgical devices 300 and 400 may include asensor, not shown, operatively connected thereto and in operativecommunication with suction lumens 304 and 404 and/or electrodes 310 and410. The sensor may be configured to detect the direction that surgicaldevices 300 and 400 are moving. The sensor may also be configured todetect pressure changes at electrodes 310 and 410. The sensor may beconfigured as part of a temperature control circuit in conjunction withthe fluid source.

With reference to FIG. 23 there is shown a flow chart 600 illustrating amethod for performing a surgical procedure. According to an exemplarymethod of operation, illustrated at step 602, a surgical device, foroperation on a target tissue, is provided. The device includes a shaft,the shaft defining a longitudinal axis therethrough and a suction lumen.The shaft adapted to connect to at least one outside source. The devicealso includes an electrode operatively connected to the shaft andsupported at a distal end thereof. The electrode includes a scrapingedge. At least a portion of the electrode is disposed in a fixed spacedapart relation relative to the suction lumen such that lumen mayaspirate coagulated tissue. Illustrated at step 604, electrosurgicalenergy to the electrode, for achieving a desired tissue effect to atarget tissue, is applied. Illustrated at step 606, at least a portionof the target tissue is scraped. Illustrated at step 608, at least aportion of the target tissue is aspirated.

Although the subject devices, systems and methods have been describedwith respect to preferred embodiments, it will be readily apparent, tothose having ordinary skill in the art to which it appertains, thatchanges and modifications may be made thereto without departing from thespirit or scope of the subject of the present disclosure.

What is claimed is:
 1. A surgical device for operation on a targettissue, the device comprising: a tubular body portion defining a lumentherethrough; and a hollow electrode extending along an outer surface ofthe tubular body, the electrode including a first portion extendingalong a length of the tubular body, a second portion extending radiallyalong at least a portion of the periphery of the tubular body, and athird portion extending along a length of the tubular body, wherein aproximal end of each of the first and third portions of the electrode isfluidly connected to a fluid source.
 2. The surgical device according toclaim 1, wherein the interior of the lumen is coated to preventclogging.
 3. The surgical device according to claim 2, wherein theelectrode is fabricated from an electrically conductive material, andwherein an insulative coating is disposed over at least a segment of theelectrode.
 4. The surgical device according to claim 3, wherein thesecond portion of the electrode extends by an angle of less than about180°.
 5. The surgical device according to claim 3, wherein the secondportion of the electrode extends by an angle of greater than about 180°.6. The surgical device according to claim 1, wherein the first and thirdportions of the electrode are covered with an insulative material. 7.The surgical device according to claim 1, wherein a vacuum source isfluidly connected to the lumen of the tubular body.
 8. The surgicaldevice according to claim 1, further comprising a scraper extendingdistally from the tubular body.
 9. The surgical device according toclaim 8, wherein the scraper is slidably supported on the tubular bodyand is movable relative to the tubular body.
 10. The surgical deviceaccording to claim 1, wherein at least the second portion of theelectrode is electrically connected to an electrosurgical energy source.11. The surgical device according to claim 1, wherein the radial portionof the electrode has a conductive coating for further reducing char anddrag on the electrode.